Canterbury District Health Board Public Health Plan

Transcription

1 Canterbury District Health Board Public Health Plan Canterbury District Health Board Public Health Earthquake Recovery Plan THE CANTERBURY HEALTH SYSTEM - working together to

2 CONTENTS 1. Canterbury District Health Board s Public Health Plan for a. Our Public Health Service 3 b. Our Key Priorities 4 c. Alignment with National and Regional Strategic Health Priorities 4 d. A Renewed Focus 5 2. Key Relationships 6 3. Outcomes framework 8 4. Health Assessment and Surveillance 9 a. Strategies 9 b. Outcomes and table 9 5. Public Health Capacity Development 13 a. Strategies 13 b. Outcomes and table Health Promotion 20 a. Strategies 20 b. Outcomes and table Health Protection 32 a. Strategies 32 b. Outcomes and table Preventive Interventions 49 a. Strategies 49 b. Outcomes and table Glossary/Definitions APPENDIX 54 A comprehensive approach to Public Health issues 54 2

3 1. CANTERBURY DISTRICT HEALTH BOARD S PUBLIC HEALTH PLAN FOR Canterbury DHB Mission: To improve, promote and protect the health of the people in the community and foster the wellbeing and independence of people who experience disabilities and reduce disparities. Canterbury DHB Vision - Tā Mātou Matakite: To improve, promote, and protect the health and well-being of the Canterbury community. Ki te whakapakari, whakamanawa me te tiaki i te hauora mō te oranga pai o ngā tāngata o te rohe o Waitaha Canterbury DHB Values A Mātou Uara: Care and respect for others - Manaaki me whakaute i te tangata. Integrity in all we do - Hāpai i ā mātou mahi katoa i ruka i te Pono Responsibility for outcomes - Te Takohanga i ngā hua. This plan accompanies the CDHB Annual Plan and has been endorsed by the Executive Management Team and Board of the CDHB. It describes public health services provided or funded by the CDHB and its Public Health Unit and highlights key relationships with other agencies. The plan is based on a South Island planning template utilising the Core Public Health Functions framework. a. Our Public Health Service Community and Public Health () is the public health division of the Canterbury DHB and provides public health services to Canterbury, the West Coast and South Canterbury. Following the February 2011 earthquake, restructured its Christchurch office to reflect the expectation of a significant focus on Public Health recovery for the foreseeable future. The decision was made that Public Health recovery would be an intrinsic part of the annual Canterbury DHB Public Health Plan, as opposed to creating a standalone recovery plan. The Christchurch staff of work in a Team structure based on four areas of focus: Information, Analysis and Support (Information Team) Health in All Policies (Policy Team) Health Protection (Protection Team) Community Engagement and Resiliency (Communities Team). Public health activities involve working in partnership with health and non-health agencies to improve health outcomes via a determinants approach. This plan, while primarily concerned with the work of Community and Public Health, also includes other DHB-funded public health activities, in particular those delivered by the Planning and Funding division of the CDHB and by the three Primary Health Organisations in the Canterbury region. The plan does not cover the work of non-dhb funded public health providers, such as non-government organisations, Māori and Pacific providers and private providers. Canterbury is currently the second largest DHB in New Zealand by population. The resident population of the Canterbury region has increased by 3.4% since the 2006 Census (482,180 in 2013 compared to 466,400 in 2006). There has been some slowing of the rate of population growth since the 2006 Census, which is likely to be partly due to due to the Canterbury earthquakes, but also reflects a slowing of population growth rate at the national level. Canterbury has the largest total population aged over 75 of any DHB. At the 2013 Census 15% of the Canterbury population was aged 65 years or older, which is higher than the 14.3% of the total New Zealand population falling into this age group. 3

4 The Canterbury population is also becoming more ethnically diverse, with greater proportions of Māori, Pacific and Asian ethnicities in 2013 than in Both Māori and Pacific populations have more youthful populations and higher fertility rates, meaning these populations are also growing faster than the total population. The population of males aged years increased substantially between 2006 and 2013, reflecting the influx of workers for the Christchurch rebuild. The Canterbury population was relatively less socioeconomically deprived than the total New Zealand population at the time of the 2013 Census. For example, just over 9% of the population was in the two most deprived deciles (deciles 9 and 10) using NZDep2013, compared to 20% of the total New Zealand population. Māori and Pacific people are more likely to be living in more deprived areas than the non-māori, non-pacific population group. This socioeconomic disparity is less pronounced in Canterbury than nationally. The work of this plan is guided by the following public health principles: a. focusing on the health of communities rather than individuals b. influencing health determinants c. prioritising improvements in Māori health d. reducing health disparities e. basing practice on the best available evidence f. building effective partnerships across the health sector and other sectors g. remaining responsive to new and emerging health threats. b. Our Key Priorities The strategic direction of the Canterbury DHB is towards transformation of the health system, based around a continuum of care approach where the traditional boundaries within the system are removed, integrating and streamlining service delivery and ultimately resulting in improved outcomes for the population. This direction is dependent on achieving a truly integrated, approach where everyone in the health system works together to do the right thing for the individual and for the system. c. Alignment with National and Regional Strategic Health Priorities This plan aligns with national and regional priorities and includes activities that support strategic health initiatives. The five South Island DHBs together form the South Island Alliance, which is committed to a sustainable South Island health system focused on keeping people well and providing equitable and timely access to safe, effective, high-quality services, as close to people s homes as possible. 1 A set of high level regional outcomes has been developed by the Alliance, which includes the outcome Improved environments to support health and wellbeing. The plan is aligned with and sits alongside the Canterbury DHB Annual Plan and Statement of Intent and the CDHB Māori Health Action Plan Community and Public Health activities are carried out under the public health service specifications as agreed by the Ministry of Health. The NZ Public Health and Disability Act lays out the responsibilities that DHBs have in ensuring Māori health gain as well as Māori participation in health services and decision making. The Canterbury DHB works in partnership with local iwi to reduce inequalities and improve the health status of Māori. Community and Public Health is part of the South Island Alliance s South Island Public Health Partnership, which is a collaboration of the three South Island Public Health Units. 1 Draft South Island Regional Health Services Plan

5 South Island population health priorities for 15/16 are: Reducing alcohol-related harm to communities via DHB Alcohol Harm Reduction Strategies. Tobacco control advancing achievement of a Smokefree Aotearoa by 2025, via growing public support for this goal. Promoting environmental sustainability to improve population health and equity as well as system sustainability through enhancing DHB leadership and action and raising public awareness (particularly of links between climate change and health). Obesity prevention through effective joined-up approaches. This plan also outlines how Community and Public Health will meet the statutory responsibilities of a Public Health Unit and its designated officers in Canterbury, as specified by the Ministry of Health. Reporting against this plan will meet the requirements of the Ministry of Health reporting schedule and ISE (Information Supporting the Estimates of Appropriation) reporting as outlined in the planning and reporting package for d. A Renewed Focus The five core public health functions agreed by the Public Health Clinical Network 2 and included in the draft revised Ministry of Health Tier Two and Three Public Health Service Specifications are: 1. Health assessment and surveillance 2. Public health capacity development 3. Health promotion 4. Health protection 5. Preventive interventions. This plan groups public health initiatives according to their primary public health function. However, the core public health functions are interconnected; core functions are rarely delivered individually. Effective public health service delivery generally combines strategies from several core functions to achieve public health outcomes in one or more public health issue or setting. The appendix outlines how public health strategies from a range of core functions are combined across the CDHB to address the priority health issues of tobacco control and alcohol harm reduction. 2 Available at 5

6 2. KEY RELATIONSHIPS The Public Health work of the CDHB involves partnership with many health and non-health agencies. Some key partners of Community and Public Health are listed below. Formal agreements are noted in parentheses. Local authorities: Environment Canterbury (ECan) (joint work plan) Christchurch City Council (joint work plan) Waimakariri District Council Selwyn District Council Hurunui District Council Kaikoura District Council Ashburton District Council District Licensing Committee (DLC) Government agencies: Alcohol Regulatory and Licensing Authority Canterbury Earthquake Recovery Authority (CERA) (MoU for Community Wellbeing Survey) Department of Conservation Environmental Science and Research Environmental Protection Authority Health Promotion Agency Health Quality and Safety Commission NZ (HQSC) Housing New Zealand Ministry of Business, Innovation and Employment Ministry of Education Ministry for the Environment Ministry of Health Ministry for Primary Industries Ministry for Social Development New Zealand Fire Service New Zealand Police Māori / Iwi agencies: Ngāi Tahu He Oranga Pounamu (HOP) Mana Whenua ki Waitaha Primary care: Pegasus Health Christchurch Primary Health Organisation Rural Canterbury Primary Health Organisation 6

7 Educational institutions: Christchurch Polytechnic Institute of Technology University of Canterbury University of Otago, Christchurch (MoU with CDHB) Schools participating in the Health Promoting Schools initiative Cognition Education Non-Government Organisations/Networks: Action on Smoking and Health (ASH) Cancer Society Earthquake Disability Leadership Group Family Planning Association Disability Information Service Heart Foundation Laboratories Mental Health Foundation (MoU around wellbeing campaign) Smokefree Canterbury (joint MoU with other partners) Sport Canterbury Private sector: Canterbury International Airport Limited (CIAL) Lyttelton Port Company International Accreditation New Zealand (IANZ) 7

8 3. OUTCOMES FRAMEWORK 8

9 4. HEALTH ASSESSMENT AND SURVEILLANCE a. Strategies Monitoring, analysing and reporting on population health status, health determinants, disease distribution, and threats to health, with a particular focus on health disparities and the health of Māori. Detecting and investigating disease clusters and outbreaks (both communicable and non-communicable). understanding health status, health determinants and disease distribution b. Outcomes and table Health assessment Short Term Outcomes Robust population health information available for planning health and community services Monitor, analyse and report on key health determinants, including the review of the City Health and Wellbeing Profile issues papers. Develop/update health status reports and health needs analyses for specific populations. Develop disease-specific reports for outbreaks and conditions of concern, eg Pertussis. (Information, Policy), P&F, Primary Care (Information), P&F, Primary Care Number of reports updated Number of reports Accessibility of reports including web statistics. Formal/informal feedback Accessibility of reports. Formal/informal feedback (Information) Number of reports Accessibility of reports. Formal/informal feedback. Availability of information for planning 9

10 Short Term Outcomes Improved public understanding of health determinants Develop communicable disease-specific profiles to identify at-risk groups. Contribute to update of South Island alcoholrelated harm indicators. Contribute to related work of partner organisations, eg CERA Canterbury Wellbeing Index and Wellbeing Survey Contribute to new Canterbury Clinical Network Exercise as medicine workstream Disseminate information in existing and dedicated reports (eg CDHB Quality Accounts; CDHB,, and Healthy Christchurch websites; Health in All Policies newsletter; and print, broadcast and social media). (Information) Number of reports. Accessibility of reports. (Information), SI Partnership (Alcohol Workstream), Alcohol Harm Minimisation Coordinator (Information), P&F A set of common indicators is produced annually for each SI DHB. Formal/informal feedback Effectiveness of contribution. Quality of working relationship. (Policy) Record of contribution Effectiveness of contribution. (Communications, Information, Policy), CDHB Communications Team Number of reports. Formal/informal feedback Availability of information to public 10

11 Short Term Outcomes Maintain effective working relationships with media. (Communications) Number of media reports. Nature of media reports Surveillance Prompt identification and analysis of emerging disease trends, clusters and outbreaks Review (via EpiSurv and other sources), analyse and report on communicable diseases data, including via web applications and written reports (eg Public Health Information Quarterly, weekly reports on notifiable diseases and influenza -May to September). Produce disease-specific reports for communicable diseases of concern, eg Pertussis, other diseases causing outbreaks. Review, analyse and report on other disease and determinants data (eg alcohol-related harm, and diseases relevant to post earthquake context eg mental illness, respiratory disease) including via the (Information, Protection), Primary Care (Information, Protection) (Information), P&F, Primary Care, Alcohol Harm Minimisation Coordinator Number of reports. Number of reports. Record of progress. Accessibility of reports. Formal/informal feedback Accessibility of reports. Formal/informal feedback Timeliness and effectiveness of reports for identifying trends and outbreaks of concern 11

12 Short Term Outcomes Environmental Health. Provide reports to SI Rheumatic fever register, SI Partnership Record of progress 12

13 5. PUBLIC HEALTH CAPACITY DEVELOPMENT a. Strategies Developing and maintaining public health information systems. Developing partnerships with iwi, hapü, whānau and Māori to improve Māori health. Developing partnerships with Pacific leaders and communities to improve Pacific health Developing human resources to ensure public health staff with the necessary competencies are available to carry out core public health functions. Conducting research, evaluation and economic analysis to support public health innovation and to evaluate the effectiveness of public health policies and programmes. Planning, managing, and providing expert advice on public health programmes across the full range of providers, including PHOs, Planning and Funding, Councils and NGOs. Quality management for public health, including monitoring and performance assessment. b. Outcomes and table enhancing our system s capacity to improve population health Public health information systems Short Term Outcomes Public health information accessible to public health, partner organisations and the public Review and maintain public health information systems (common file structure; databases; intranet, extranet and public websites, including Healthscape, SIPHAN, GIS systems, Health Pathways, HIIRC, NIR; (Information, Communications), P&F, Primary Care Level of utilisation Completeness and currency of information Operational systems and documentation in place Upgrade of systems to current technical standards Availability and accessibility of public health information 13

14 Partnerships with iwi, hapü, whānau and Māori Short Term Outcomes Effective partnerships with iwi, hapü, whānau and Māori Community Health Information). Contribute to development and implementation of national, regional and local public health information systems, including providing support to other PHUs that are adopting Healthscape. Work with local iwi, hapü, whānau and Māori around: -health information and analysis (including promoting Information Team services) -proposals and policies with health implications -health determinants and outcomes. Implement Māori Health Plan. (Information) (All Teams), Primary Care (Māori Health Sub- Group) Summary reporting of interactions with partner agencies at regional and national level No. of initiatives supported. Nature and effectiveness of systems, including degree of integration or interoperability. Formal/informal feedback. Progress against plan Joint approaches and initiatives Contribute to implementation of overarching Canterbury Māori Health Framework. (Māori Health Sub- Group), P&F, Primary Care Progress against plan. 14

15 Partnerships with Pacific and other ethnic leaders and communities Short Term Outcomes Effective partnerships with Pacific and other ethnic communities SI: Work with Mäori GMs and Te Herenga Hauora, eg around shared communications. Work with local Pacific and other ethnic leaders and communities around: -health information and analysis (including promoting Information Team services) -proposals and policies with health implications -health determinants and outcomes. Contribute to implementation of CDHB Pacific Health Framework. (GM and Māori Portfolio on SI Public Health Partnership) (All Teams), Primary Care (Communities), P&F, Primary Care No. of initiatives supported. Record of interactions and outcomes Formal and informal feedback. Progress against plan. Joint approaches and initiatives Human resources A highly skilled public health workforce Participate in Pacific Island Reference Group. Support the implementation of the Pacific (Earthquake) Recovery Action Plan. Implement the Workforce Development Plan, including promoting a focus on specific competencies and (Communities, Policy) (Communities) (Information), SI Partnership Record of Learning and Development opportunities. Record and impact of participation. Progress against plan. Feedback from other PHUs % Staff with appropriate or relevant public health qualifications 15

16 Short Term Outcomes contributing to SI workforce development and national networks. Assess the applicability of the Health Protection Officer competencies project and decide whether CDHB () will adopt it. SI: Contribute to regional workforce development processes. (Protection, Information) (All Teams, Information Lead) Record of assessment and decision. Record of contribution (Note: refer pp 8-9 of Guidance overview in Planning and reporting package for detail) Research, evaluation, economic analysis Planning and advising on Information available on priority public health issues and effectiveness of public health interventions Population health interventions are based on best Support public health research and evaluation, (including earthquake recovery research) with a particular focus on improving Māori health and reducing health disparities. Systematically identify opportunities for conference presentations and peer-reviewed publication. Develop reports and advice for health and nonhealth organisations to (Information, Policy) (All Teams) (Information, Policy), P&F, Primary Care, SI Partnership Number and accessibility of reports. Formal/informal feedback Number of presentations and publications. Number of reports. Impact of presentations and publications. Accessibility of reports. Formal/informal feedback. Research / evaluation reports and publications Planning advice / reports 16

17 public health programmes Quality management Short Term Outcomes available evidence and advice A continuous improvement culture and robust quality systems for all public health work support robust public health interventions, with a focus on improving Māori health and reducing health disparities, including evidence reviews, needs assessments, evaluations, GIS analysis. Contribute to national, regional and local public health infrastructure and supports, including Public Health Association, Health Promotion Agency, Health Promotion Forum, South Island Public Health Partnership, South Island Public Health Analysts Network, National Public Health Clinical Network, National Health Promoting Schools Group, New Zealand College of Public Health Medicine. Review and deliver the quality improvement plan, including: policy and procedure maintenance; internal audit plan and (All Teams) (Information) Record and impact of contribution. Progress against plan, eg review of policies and procedures and internal audits. Quality improvement plan and reports Accreditation results 17

18 Short Term Outcomes Effective regional delivery of public health core functions provision of information, training and support to staff. Present annual quality report to Divisional Leadership Team. Contribute to the CDHB organisation-wide quality programme. Maintain IANZ accreditation of drinking water unit and plan to ensure sufficient accredited Drinking Water Assessors at all times. Contribute to management and work groups as per South Island Public Health Partnership Plan : SI Population health analysts network SI Alcohol workgroup SI Smokefree 2025 group SI Sustainability workgroup (Information) 1 report annually Progress against improvement recommendations log. (Information) (Information), SIDWAU (All Teams) Progress towards quality programme Accreditation maintained Progress against plan. Partnership evaluation. Reports of South Island Public Health Partnership 18

19 Short Term Outcomes SI Obesogenic environments workgroup (to be confirmed) Management group. 19

20 6. HEALTH PROMOTION a. Strategies Developing public and private sector policies beyond the health sector that will improve health, improve Māori health and reduce disparities. Creating physical, social and cultural environments supportive of health. Strengthening communities capacity to address health issues of importance to them, and to mutually support their members in improving their health. Supporting people to develop skills that enable them to make healthy life choices and manage minor and chronic conditions for themselves and their families. Working in partnership with other parts of the health sector to support health promotion, prevention of disease, disability, injury, and rational use of health resources b. Outcomes and table enabling people to increase control over and improve their health Building Public Policy Short Term Outcomes Increased numbers of sustainable policies and practices that support health and wellbeing, improve Māori health, and reduce disparities Develop and make available resources to support health impact assessment (HIA) and a health in all policies (HiAP) approach. Support health and nonhealth sector staff with appropriate tools and customised advice to enable a HiAP approach (Policy) (Policy) Record of contributions and their impact. Record of contributions. Formal/informal feedback New and reviewed strategies, plans and policies reflect health priorities 20

21 Short Term Outcomes eg the IRPG (Integrated Recovery Planning Guide), Te Pae Mahutonga, HPSTED (Health Promotion and Sustainability Through Environmental Design), Broadly Speaking Training, etc. Ensure these tools are available to all partner agencies and support their implementation. Support settings (ie workplaces, schools) to develop strategies/activities which support health. Engage with and coordinate efforts of key external agencies, including CERA and local iwi, to identify and support HIAP opportunities, including housing, transport, and earthquake rebuild. (Communities), (Policy) Estimate: two workplaces, 50 schools supported Record of contributions. Record of contributions. Formal/informal feedback 21

22 Short Term Outcomes Implement, review and update joint work plans with ECan and CCC. Explore opportunities to develop further joint workplans as relevant, including undertaking the development of a tripartite work plan between CDHB, Environment Canterbury and CCC. Support and co-ordinate development of CDHB and regional position statements and submissions on public health issues. Support or coordinate CDHB-wide submissions on documents with public health implications and/or identified by the CDHB Board as relevant to the CDHB. Co-ordinate/provide feedback to TLAs on Long (All Teams, Policy and Communities Lead) (All Teams, Policy Lead) (All Teams), SI Partnership Two joint workplans in place Number of position statements and submissions. Formal/ informal feedback, including evaluation of joint work plans. Record of progress. Formal/ informal feedback, including evaluation of joint work plans. Impact of position statements and submissions. (Policy) Number of submissions. Impact of submissions. (Policy, Protection) Record of contribution Impact of contribution 22

23 Built Environments Creating supportive environments Education settings Short Term Outcomes Built environments promote health, and support healthy choices and behaviours Settings that support healthy choices and behaviours ECECs, schools and tertiary settings that support healthy choices and behaviours Term Plans on behalf of CDHB. Encourage the development of welldesigned built environments (including transport networks and public spaces and promotion of urban design guidelines) that are universally accessible and promote health. Work across networks to initiate and embed policies and programmes which support healthy choices, eg Greater Christchurch Psychosocial Committee, Resilient Cities, and refugee groups. Develop and support health promoting schools initiatives, reflecting national strategic direction and service specification. (Policy) (Policy, Communities) (Communities) Number of position statements and submissions Record of contribution Number of schools engaged. Impact of position statements and submissions Level of involvement in the drafting of Council plans and policies e.g. HIA work Contribution evident in decisions/outputs, including Council plans and policies, e.g. smokefree, psychoactive substances Use of national HPS review tool indicates high levels of successful engagement and collaboration. Evidence of Public Health contribution in key decisions Number and type of settings that embed a systems approach to improving health Education settings evaluation reports 23

24 Short Term Outcomes Develop school action plans with strategies to address priority issue areas, eg Smokefree, mental health and wellbeing, nutrition, physical activity. (Communities) Number of action plans. Priority issues identified and addressed in action plans. Facilitate school forums (Communities) Estimate: Three forums held. Establish cross agency, collaborative, schoolwide mental health initiatives Support schools in earthquake recovery context (with information, tailored interventions). Eg, Aranui Campus. Develop Health Promotion plans in Tertiary Institutions, including University of Canterbury and Christchurch Polytechnic Institute of Technology. Scope opportunities for engagement with priority ECECs. (Communities) (Communities) (Communities) (Communities) Number of cross agency initiatives. Number of schools supported Estimate: Two Health Promotion plans established Evaluation of outcomes. Evaluation of outcomes. Record of outcomes. Evaluation of outcomes. Scoping report complete. 24

25 Workplaces Short Term Outcomes Workplaces that support healthy choices and behaviours Scope needs of Pacifica and Māori workers. Develop a strategy for promoting workplace health. (Communities) Scoping report complete. Workplace initiatives and evaluation reports (Communities) Workplace Health strategy developed. Work with priority workplaces and partners/networks to develop health promoting workplace plans. (Communities), Smokefree ABC Team Estimate: Three priority workplaces engaged and plans developed. Marae and other Māori settings Marae and other Māori settings that support healthy choices and behaviours Work with Marae, Runaka, and other Māori settings (eg Kohanga Reo, Tane Ora, community hubs) to support healthy choices and behaviours. SI: Develop and disseminate an Alcohol Harm Reduction kit for whānau (along lines of Northland s whanau pack) with support from Māori GM. (Communities), Smokefree ABC Team SI Alcohol Workgroup and Māori GMs No. of Māori settings worked with. No. of initiatives supported eg Auahi Kore, alcohol. No. of Tane Ora initiatives. Formal/informal feedback including evaluation findings. Feedback and demand for further kits Marae and other Māori settings initiatives and evaluation reports 25

26 Other community settings Community action Short Term Outcomes Other community settings that support healthy choices and behaviours Effective community action initiatives Support communities to address priority issues, including community engagement initiatives and development of health promotion settings eg active transport (via initiatives such as ICECycles, Bikewise, bike to work day and walk to work day), food security, wellbeing, smokefree. Coordinate collaborative projects including eg: Healthy Christchurch, housing, alcohol harm minimisation coordination, Warmer Canterbury, community resilience projects, All right? Mental Wellbeing Campaign, integration of migrant workforce, Smokefree parks and playgrounds, and Te Wai Pounamu Māori Leadership Group for Cancer. (Communities) (Communities, Policy) No. of groups/settings engaged with. No. of initiatives supported and evaluated. No. of collaborative projects No. of regional and national networks attended Evaluation findings. Formal and informal feedback including evaluation findings. Setting initiatives and evaluation reports Changes achieved by community partnerships 26

27 Short Term Outcomes Provide information about community engagement initiatives, community resilience activities, etc to community organisations through the Healthy Christchurch and All Right? websites. Support the implementation of the Resilient Cities framework (Policy, Communities) (Policy) Website statistics. Formal/informal feedback. Record of contribution Support the planning, implementation and evaluation of Healthy Families NZ communities (in Spreydon-Heathcote, Christchurch), including via membership of the Governance Group (Communities) Contributions recorded in Healthscape Support Social Sector Trial initiatives in the community (Communities) Number of collaborative projects developed and delivered under the Shared Programme Of Action (Greater Christchurch Community In Mind Strategy) Contributions recorded in Healthscape 27

28 Develop personal skills Short Term Outcomes People with skills to enable healthy choices and behaviours Deliver Aukati Kai Paipa and other cessation support. Strengthen the referral pathway between hospitals and cessation providers. (Communities), Primary Care Smokefree ABC team Number of referrals from CDHB to cessation providers Progress against AKP contract specifications Smoking quit rates Evaluation of other initiatives Develop and deliver other lifestyle intervention support (eg Appetite for Life, Green Prescription, nutrition/cooking and/or physical activity programmes for Māori and Pacific people, seniors, children and young people, and new migrants, fall prevention programmes, breastfeeding support) (Communities), Primary Care, Other CDHB Teams / Services (eg Oral Health, Mental Health ) Record of interventions. Formal/informal feedback, including evaluation findings. Communities aware of health issues and healthy choices and behaviours Deliver safe sexual health education and resources to priority groups. Develop and implement CDHB public health communications strategies. (Communities) (All Teams, Communications Lead) No. of resources distributed. No. of education sessions delivered. Progress against strategies Formal and informal feedback. Communications Plan, record of campaigns and information delivered 28

29 Reorient health service Short Term Outcomes Preventative and population approaches support healthy choices and behaviours in healthcare settings Deliver/support relevant and timely public health information and campaigns (including All Right? Mental Wellbeing Campaign, White Ribbon Day, the It s not OK campaign, World Smokefree Day, Mental Health Awareness Week, alcohol harm awareness/minimisation initiatives, cycling events, CTV slots, video, Voice of Pacific Women, Health Promoting Schools magazine). Support achievement of Smokefree Health target in Secondary and Primary care Work with hospital and community healthcare providers to develop health promoting settings (eg promoting support for travel planning with a (All Teams, Communications Lead), Alcohol Harm Minimisation Coordinator CDHB Smokefree ABC Team (Communities, Policy), Primary Care, CDHB Wellbeing Coordinator, CDHB Sustainability Advisor No.and type of public health messaging distributed. No. of initiatives. Evaluation of reach and impact of individual campaigns Progress against Health Target 5: Better support for smokers. Evaluation findings. ABC coverage in primary and secondary care. Healthcare initiatives and evaluation reports 29

30 Short Term Outcomes focus on modal shift from cars). Plan, promote and implement targeted wellbeing initiatives for CDHB staff. Actively engage in supporting a healthy settings approach in the facilities redevelopment process. Sustainability-focused project internal to CDHB as part of wider SI PH Partnership initiative, including a green and healthy hospitals communications plan (see SI Public Health Partnership 14/15 Annual Workplan). Contribute to the CDHB Mental Health Workstream, Child and Youth Workstream of the Canterbury Clinical Network, Flexible Funding Service Level Alliance and (Policy, Communities), CDHB Wellbeing Coordinator, CDHB Staff Wellbeing Action Group Record of initiatives. Formal/informal feedback. (Policy) Record of contribution. Impact of contribution. SI Partnership, CDHB Sustainability Advisor Record of initiatives. Formal/informal feedback. (Communities) Record of contribution. Impact of contribution. 30

31 Short Term Outcomes CDHB Staff Wellbeing Action Group. SI: Promote a population health approach to tackling obesity with other parts of our DHB and via SI SLAs and workstreams. Develop CDHB Alcohol Harm Reduction Strategy as a sub strategy of a wider city Alcohol Harm Reduction Strategy (under CCC-CDHB workplan) Work with University of Otago to educate medical students about health promotion and social marketing in community settings. (Communities and Policy), SI Partnership Alcohol Harm minimisation Coordinator, (Policy, Communities, Protection) (Communities) Record of initiatives. Alcohol Harm Reduction Strategy in place by end of Estimate: 12 seminars and community visits Formal/informal feedback. Student feedback 31

32 7. HEALTH PROTECTION a. Strategies protecting communities against public health hazards Developing and reviewing public health laws and regulations 3. Supporting, monitoring and enforcing compliance with legislation. Identifying, assessing, and reducing communicable disease risks, including management of people with communicable diseases and their contacts. Identifying, assessing and reducing environmental health risks, including biosecurity, air, food and water quality, sewage and waste disposal, and hazardous substances. Preparing for and responding to public health emergencies, including natural disasters, hazardous substances emergencies, bioterrorism, disease outbreaks and pandemics. b. Outcomes and table Communicable disease control Short Term Outcomes Reduced incidence of notifiable diseases Reduced incidence of influenza Investigate cases and contacts as per protocols and Communicable Disease Control Manual 2012, including timely identification and Disease rates and trends Notifiable diseases and influenza rates and trends Outbreak rates and trends 3 Public health legislation covers a wide variety of issues, including communicable disease control, border health protection, food quality and safety, occupational health, air and drinking water quality, sewerage, drainage, waste disposal, hazardous substances control, control of alcohol, tobacco and other drugs, injury prevention, health information, screening programmes, and control of medicines, vaccines and health practitioners. 32

33 Short Term Outcomes investigation of notifiable diseases and outbreaks. Review communicable disease protocols Quality data entry in EpiSurv in a timely manner. Carry out internal audits of selected cases for adherence to protocols. (Information) Estimate:10 protocols reviewed Statistics as outlined in the ESR Annual Data Quality Report and Annual Outbreak Report is on or above national average. 4 audits annually Data quality as outlined in the ESR Annual Data Quality Report. Deliver education to hospital based practitioners and nursing staff about timely notification on clinical suspicion: -input to Health pathways portal -house surgeon training programme -work with quality leader/moh., Primary Care, Infection Control Committee Immunisation committees, including ISLA Number of presentations given to CDHB/NGO community groups Advocacy for public health outcomes in above forums as evidenced by meeting minutes. Provide public information and advice, including promoting Number of media releases and promotional opportunities. 33

34 Short Term Outcomes immunisation and hand hygiene. Work with priority settings and communities to increase immunisation and improve infection control. Infection Control Committee, Immunisation committees, including ISLA Numbers of network groups, liaison and interagency meetings attended. Work with the refugee and migrant community to facilitate health screening and first introductory visits (FIV s). Number of refugee health screens completed and FIV s organised. Routinely offer Communicable Disease Information to Culturally and Linguistically Diverse (CALD) Communities. Number of network groups, liaison and interagency meetings attended. Impact of contribution as evidenced by meeting minutes Provide vaccinator and programme authorisations as per Medicines Regulations. Contribute to development and implementation of SI Rheumatic Fever Prevention Plan (reported through SI Public Health Partnership). Documented numbers of authorised vaccinator & programme applications and approvals. Progress against Plan. 34

35 Border health protection Short Term Outcomes Reduced international spread of infectious disease Maintain the rheumatic fever register. Undertake six-monthly reviews of prophylaxis compliance in primary care. Six-monthly review carried out and data provided to South Island Alliance and Ministry of Health Provide pratique. Number of pratiques granted. Issue ship sanitation certificates. Assess port and airport compliance with IHR and Health Act requirements. Undertake routine monitoring for exotic mosquitoes at port and airport. Respond and Investigate interceptions of pests and cases of imported disease as per protocols. Maintain 24 hour coverage to respond to incidents and emergent issues as per protocol Number of ship sanitation certificates granted. Record of results on the National Mosquito Surveillance Database. Record of interception actions and investigations. Record of response to border health incidents. IHR reports completed Evidence of imported or exported disease Port and airport compliance with International Health Regulations and Health Act quarantine requirements Exotic mosquito surveillance reporting 35

36 Drinking water quality Short Term Outcomes Optimised adequacy, safety and quality of drinking water in Canterbury Prevention of spread of disease to the public through reticulated water supplies Provide assistance with incursions as requested by MoH. Attend border and other intersectoral meetings with relevant agencies and organisations on matters relating to border health protection. Provide advice to relevant agencies and organisations on matters relating to border health protection. Support local authorities to maintain catchment protection Provide technical advice on public health aspects of drinking water supplies, including the implications of the Health Act 1956 and the DWSNZ to water suppliers, councils and organisations. Record of assistance provided during incursions. Record of meetings (quarterly meetings usually held with Port and airport authorities) Record of advice in Healthscape Records of interactions recorded in Healthscape Record of interactions with suppliers concerning their legislative obligations (in SIDWAU filing system). Professional level of advice given. Number of supplies with approved and implemented Water Safety Plans 36

37 Short Term Outcomes Carry out functions and duties of a DWA as defined under the Health Act. DWA activities completed within legislative timeframes. Undertake Annual Survey. Annual Survey data provided by required date. Carry out public health grading of drinking water supplies on request. Provide drinking water input into RMA submissions. (See Resource Management activities) Contribute to Canterbury Water Management Strategy via Zone Committees and catchment workshops. (See Recreational Water activities) Respond to respond to transgressions and suspected water borne disease outbreaks and cases. (See Communicable Disease activities) Record of input into submissions (See Resource Management) Gradings completed and entered on WINZ Meet requirements of / ECan Joint Work Plan. Timely professional investigation reports produced. Recommendations provided that will prevent recurrence of incident suspected/confirmed 37

38 Sewage Short Term Outcomes Reduced incidence and impact of environmental hazards from the treatment and disposal of sewage Work with councils to promote and ensure safe sewage disposal including making submissions on regional plans and policies, district plans and policies, resource consents. (See also Resource Management activities) Work with councils to manage risks of unplanned contamination events. Liaise with councils to provide public advice on safe sewage disposal, sewage overflows, and waterways contamination. Investigate clusters and cases of illnesses associated with nonoccupational exposure to sewage. (see Communicable Disease) Record of external meetings attended and agreed actions. (See Resource Management for submissions) Record of overflow notifications received Record of contribution. water borne disease outbreaks Timely professional investigation reports produced. Recommendations provided that will prevent recurrence of incident Sewage-related outbreaks Environmental contamination events 38

39 Short Term Outcomes (See Communicable Disease) Recreational water Reduced incidence and impact of environmental hazards associated with recreational waters. Agree recreational water protocols with councils annually. Work with councils to provide public information and advice, including health warnings and media releases and gradings where there is a potential public health risk from recreational water, shellfish growing waters or shellfish. Contribute to Canterbury Water Management Strategy via Zone Committees and catchment workshops. Respond to recreational water (including swimming pools) and shellfish cases of illness. Agreed protocol in place Waterborne disease outbreaks Beach and river water monitoring results Number of media releases produced in relation to RW including micro quality and algal bloom events. Meet requirements of /ECan Joint Work Plan. Timely investigation reports produced. Recommendations provided that will prevent recurrence of incident. 39

40 Housing Short Term Outcomes Less disease caused by inadequate housing (also see Communicable Disease) Promote NZS5862 to Councils and pool managers to maintain or improve pool water quality during any investigations. Work with relevant national, local and community organisations to ensure that population, especially vulnerable groups, has warm, dry, affordable housing (including ensuring health and non-health agencies are aware of appropriate channels for identification and referral of vulnerable households). (also see Air Quality, under Resource Management) Identify and enable referral pathways for vulnerable households. (Protection, Communities, Policy), Primary Care Record of information on NZS5862 provided during investigations Number of referrals documented in Healthscape Actions and/or outcomes from key housing stakeholder meetings/interactions reflect public health input. Housing quality improvements 40

41 Resource management Short Term Outcomes Public health issues are identified and addressed in decisions made on the sustainable management of natural and physical resources and social environments Contribute to planning processes that impact on improved housing for Canterbury. Submit on local government policies and plans including policy statements, regional plans, district plans, long term plans, sanitary works infrastructure planning and resource consent applications to ensure public health aspects are considered. Review council decisions in terms of uptake of health submissions. (Policy, Protection) Number of applications assessed (scoped). Number of submissions made. Number of hearings where evidence presented. Number of decisions reviewed. Record of contribution Evaluation of council decisions, implementation and enforcement Liaise with stakeholders, other agencies and the public on matters of public health relating to sustainable resource management. Record of external meetings (other than community meetings) attended and agreed actions. Continue to progress agreed actions outlined in CDHB/ECan Joint Work Plan and CDHB/CCC Joint Work Plan. Progress and completion of actions is recorded in CDHB/ECan reporting and CDHB/CCC reporting. 41

42 Hazardous substances Short Term Outcomes Public protected from exposure to hazardous substances Work with stakeholders to identify and address potential health issues relating to air quality. Liaise with stakeholders, other agencies and the public on matters of public health relating to sustainable resource management. Implement the Hazardous Substances Action Plan, including working with councils and other agencies to reduce public exposure to hazardous substances, including responding to hazardous substance emergencies and complaints. Conduct investigations where required, including entry into HSDIRT and response to HSDIRT notifications. Provide public information and advice (eg regarding asbestos and contaminated land). Record of community meetings attended and any agreed actions. Record of external meetings (other than community meetings) attended and agreed actions. Record of external (including HSTLC) meetings attended and agreed actions. Record of formal advice given. Number and outcome of investigations. Record of advice given, including website utilisation. Air quality monitoring results Reports of public exposure 42

43 Early childhood education centres Short Term Outcomes Reduced incidence and impact of health issues in early childhood education centres Process applications for vertebrate toxic agents under HSNO legislation and audit operations. Visit, assess for prelicensing and provide advice to ECECs. Work with councils to ensure appropriate placement of new ECECs. Number of VTA applications processed and audited. Number of ECECs assessed in terms of meeting requirements of ECC 1998/ 2008 Regulations Number of meetings held with MoE and TAs. Compliance with ECC Regulations, including infection control and lead exposure Emergency preparedness Canterbury district prepared for emergencies impacting on public health Develop and maintain emergency plans. Participate in emergency response(s) on an asneeded basis. (All Teams) Emergency Plans are current. Debrief reports Effective emergency responses as required Deliver MoH Emergency Management Training to new staff and refresher training to established personnel (Eg CIMS in Health, Health EMIS) (Protection, Information) Record of training Evaluation of training 43

44 Sustainability Short Term Outcomes Greater understanding of and action on sustainability Participate in Public Health exercise with Public Health South and Nelson/Marlborough Public Health. Contribute to the development of an integrated South Island Public Health Business Continuity Plan. Maintain relationships with ECan, Christchurch City Council, and Civil Defence Emergency Management Group. Engage with Māori in terms of Community and Public Health aspects of emergency planning. Raise awareness regarding sustainability and climate disruption, including both adaptation and mitigation strategies, eg planning for water supplies. Lead CDHB advocacy group Sustainable Health 4 Canterbury. (Protection, Information) (Protection, Information) (Protection, Information) CDHB Sustainability Advisor,, SI Sustainability Workgroup (Policy) Progress towards plan completion, implementation. Record of meetings attended Record of progress Record of activity to improve understanding of sustainability and to promote sustainable practices Estimate: 8 meetings per year with 6-weekly frequency. Performance against exercise performance measures. Impact of contribution to meetings as evidenced in meeting minutes. Evidence of increased awareness and development of sustainable approaches within our DHBs and partner organisations. 44